Anti-Depressants and cannabis (marijuana, THC)
As cannabis becomes legal or decriminalised in more jurisdictions, the practical question of combining it with prescription medication comes up regularly. Anti-Depressants (Anti-Depressants) and cannabis share several pharmacological pathways, and the combination at 10mg, 20mg, 40mg, 30mg, 60mg is not automatically benign even where both are legal.
How cannabis affects Anti-Depressants
THC and other cannabinoids are metabolised partly by hepatic CYP enzymes, including CYP3A4 — the same pathway used by many Anti-Depressants medications. Frequent cannabis use can shift the metabolism of Amitriptyline, Bupropion, Citalopram, Duloxetine, Escitalopram, Fluoxetine, Mirtazapine, Paroxetine, Sertraline, Trazodone, Venlafaxine mildly. THC also has cardiovascular effects (increased heart rate, blood pressure changes) and central nervous system effects that can stack with Anti-Depressants's side-effect profile.
Practical guidance
Occasional moderate cannabis use is unlikely to cause clinically meaningful problems for most adults on Anti-Depressants at 10mg, 20mg, 40mg, 30mg, 60mg. Heavy daily use, edibles with high THC content, or cannabis combined with alcohol substantially raise the risk of dizziness, hypotension, impaired judgement and amplified side effects from Amitriptyline, Bupropion, Citalopram, Duloxetine, Escitalopram, Fluoxetine, Mirtazapine, Paroxetine, Sertraline, Trazodone, Venlafaxine. According to the prescribing information, the full list of recreational substances should be disclosed to the prescriber.
Frequently asked questions
Can I use cannabis while taking Anti-Depressants? ▾
For most adults at 10mg, 20mg, 40mg, 30mg, 60mg, occasional moderate cannabis is tolerated, but heavy daily use is not advised because of metabolic and additive cardiovascular effects with Amitriptyline, Bupropion, Citalopram, Duloxetine, Escitalopram, Fluoxetine, Mirtazapine, Paroxetine, Sertraline, Trazodone, Venlafaxine. The safe practice is to mention it to the prescriber.
Does CBD interact with Anti-Depressants? ▾
CBD inhibits several CYP enzymes including CYP3A4, which can raise plasma levels of medications that go through that pathway. For Anti-Depressants specifically, this depends on whether Amitriptyline, Bupropion, Citalopram, Duloxetine, Escitalopram, Fluoxetine, Mirtazapine, Paroxetine, Sertraline, Trazodone, Venlafaxine uses CYP3A4. Daily high-dose CBD products warrant a pharmacist check.
Medications in Anti-Depressants
More on Anti-Depressants
- With alcoholAnti-Depressants and alcohol — is it safe to drink?
- With foodShould Anti-Depressants be taken with food?
- Side effectsAnti-Depressants side effects: common, rare and warning signs
- For older adultsAnti-Depressants after 60: doses and safety in older adults
- For womenAnti-Depressants for women: indications and considerations
- For menAnti-Depressants for men: indications and considerations
The information on this website is provided for reference and educational purposes only. It does not replace consultation with a qualified healthcare professional.